Workers' Compensation Excess/SDF Claims Specialist (Remote)

Davies • Home, AL

1d • Remote

About The Position

Davies North America is seeking a Workers' Compensation Excess/SDF Claims Specialist to submit timely and appropriate excess reports to excess companies on workers’ compensation claims on behalf of customers, in accordance with contract timelines and financial thresholds. The specialist will pursue, perfect, and manage SDF claims through conclusion in accordance with company and state regulations.

The role coordinates excess insurance documentation and reporting with clients, agents, carriers, claims staff, and internal departments. It also evaluates files for SDF potential, pursues state fund reimbursement, maintains claim documentation and diaries, and prepares status reports and reimbursement requests. This is a remote position. The company describes medical, dental, vision, retirement, time-off, holiday, life insurance, and disability benefits for qualifying employees; eligibility and offerings may vary.

Requirements

• 1–2 years of claims-handling experience in Florida workers’ compensation law.
• 1–2 years of office experience.
• Active adjuster license: Florida 5-24 or 5-20/6-20.
• Working knowledge and experience handling workers’ compensation claims.
• Knowledge of state-specific workers’ compensation statutes.
• Ability to operate a personal computer and related claims and business software effectively.
• Good oral and written communication skills and good customer service skills.
• Excellent organizational skills.
• Ability to work as a team player.
• Good attendance.

Responsibilities

• Coordinate with clients and/or insurance agents to obtain excess insurance policies and declaration pages for each year with open claims and maintain them in master account files.
• Notify each client’s excess carrier that Davies has been retained to provide Third Party Administration services and explain usual claim-reporting procedures.
• Identify retention levels for each excess policy period and additional carrier reporting requirements to the appropriate claim supervisors, claims specialists, and Information Systems department.
• Submit initial notices, follow-up or supplemental reports, and final reports to appropriate excess carriers within carrier guidelines.
• Assist claims specialists in obtaining excess-carrier settlement authority for claims expected to reach the Self-Insured Retention level and provide settlement documentation to carriers with final reports.
• Communicate with claims specialists and supervisors to ensure claims meeting excess insurance criteria are reported accurately, professionally, and on time.
• Evaluate files for SDF potential and pursue reimbursement in accordance with state requirements.
• Contact employers, attorneys, field representatives, and doctors in a timely manner.
• Notify the SDTF of potential settlements on SDF cases and advise claims specialists about the Fund’s settlement approval procedures.
• Ensure file handling includes consistent system documentation and timely compliance with state reporting requirements.
• Maintain file diaries and keep files current according to company standards.
• Correspond with excess carriers and the SDTF regarding excess and SDF issues.
• Update SDF status reports for certain clients quarterly and excess status reports for carriers on certain accounts every 3, 6, or 12 months.
• Submit initial and annual reimbursement requests to the SDTF.
• Monitor diaries, complete SI-19 forms, and facilitate customer execution and timely filing with FLDFS.
• Perform other duties as assigned.
• Maintain regular and dependable attendance and be available to perform job responsibilities during established work hours.

Benefits

• Medical, dental, and vision plans for qualifying employees.
• 401(k) plan with employer matching.
• Discretionary Time Off for exempt employees and Paid Time Off for non-exempt employees.
• Paid holidays.
• Life insurance.
• Short-term and long-term disability coverage.
• Where required by law, paid sick leave, paid family and parental leave, and other mandated benefits.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed